Classification into different patient groups – a step toward tailoring care after major oncological surgery?

Abstract

Objective: To evaluate how the distribution of patients in groups (based on subjective health experience) changes over time and to investigate differences in physical functioning and mental health between these patient groups.Design: An observational cohort studySetting: University Medical CenterParticipants: Patients who underwent gastrointestinal or bladder oncological surgeryInterventions: Not applicableMain Outcome Measures: The classification of patients into different groups based on the subjective health experience model (acceptance and perceived control), preoperatively and 1 and 3 months after discharge.Results: In total, 98 patients were included. Preoperatively, 31% of the patients were classified having low acceptance and perceived control (group 4), and this proportion increased to 47% and 45% 1 and 3 months after discharge, respectively. These patients had significantly lower levels of physical functioning (preoperatively 55 versus 61, p=0.030; 1 month 47 versus 57, p=0.002; 3 months 52 versus 62, p=0.006) and higher levels of anxiety and depression (preoperatively 14 versus 9, p=0.000; 1 month 11 versus 3, p=0.001; 3 months 10 versus 3, p=0.009) than patients with high acceptance and perceived control (group 1).Conclusion: The classification of patients to different groups provides insight in different levels of physical and mental health. However frequent evaluation is important since patient change in group over time.